A wound is defined as an injury to a part of the body. Wounds may be inflicted on a subject in any number of ways, such as by mechanical injury, burns or surgery, and have been sustained on humans and animals since time immemorial.
The process of wound healing typically undergoes four distinct phases: blood clotting (also known as hemostasis); inflammation; growth of new tissue (also known as proliferation); and remodeling of tissue (also known as maturation). The treatment of wounds, such as those mentioned above and especially those resulting from excisions or incisions, is one of the primary goals of any medical practitioner. Traditional methods of treating wounds to promote healing include keeping the wound clean and protecting the wound from harmful bacterial contamination. There have also been a number of methods developed that include application to the wound of a wound healing agent to facilitate wound healing. If the healing process can be accelerated in any way, this would be of great benefit to both a patient and a medical practitioner.
Hydroxysteroid dehydrogenases are enzymes that catalyze the dehydrogenation of hydroxysteroids. It has previously been described that 11β-hydroxysteroid dehydrogenases (HSD-11β or 11β-HSD) are a family of oxido-reductase enzymes that catalyze the conversion of cortisone to active cortisol (a glucocorticoid, GC). There are two known isoforms of 11β-hydroxysteroid dehydrogenases in humans, known as type 1 and type 2.
Glucocorticoid excess may affect skin integrity, inducing thinning and impaired wound healing. GCs may also induce a flattening of the normally undulating rete ridges at the dermal-epidermal junction leading to altered mechanical properties and delayed wound healing. Without wishing to be bound by theory, it is believed that inhibition of 11β-HSD may lead to improved wound healing in a patient.
The inventors have now surprisingly found that a specific aza adamantane compound, or a pharmaceutically acceptable salt thereof, disclosed in WO 2013/111150, filed on 21 Dec. 2012, has beneficial effects in the treatment of wounds. The entire contents of the above disclosure are incorporated herein by reference.